Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We assessed the prevalence of Campylobacter pylori in various forms of endoscopic gastritis, including ulcer and nonulcer dyspepsia and bile gastritis and correlated it with histological evidence of inflammation. Multiple biopsy specimens were taken from 120 patients, including four normal controls, who underwent upper gastrointestinal endoscopy for evaluation of upper abdominal pain and discomfort, nausea, bilious vomiting, weight loss, and anemia. The patients included 58 men and 62 women, with a mean age of 53 years. Of these, 16 patients had gastric ulcers, 19 had duodenal ulcers, 26 had reflux gastritis (after either gastric surgery or cholecystectomy), one had a gastric polyp, one had Barrett's esophagus, and the remaining 53 had gastritis due to unspecified causes. Campylobacter-like organisms were demonstrated by light and electron microscopy in 50 of 69 patients of the nonbile gastritis group (72%) and in seven of 15 patients of the bile gastritis group (47%) (p0.05). The presence of bacteria in both groups correlated with histologically significant inflammation (particularly chronic active gastritis); similar histologic changes were noted in both major groups of nonbile gastritis and bile gastritis. Campylobacter pylori is common in all forms of gastritis in association with histologic inflammation.
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PMID:The prevalence of Campylobacter pylori gastritis: a study of symptomatic nonulcer dyspepsia and bile gastritis. 278 19

Standardised household interviews among adults and children, open-ended questionnaires, and clinical examinations administered during cross-sectional health status surveys, as well as the registers of village health posts (VHP), were used to assess the pattern of health problems of a rural community in southeastern Tanzania, and their results compared. All four approaches gave very similar results for the two major health problems (fever/malaria and abdominal pain or discomfort) which were mentioned by both children and adults. The parasitological data from the cross-sectional surveys also revealed hyperendemic P. falciparum malaria and a high prevalence and incidence for infections with hookworm (N. americanus), Strongyloides, and G. lamblia. However besides consistently revealing the two major health problems, each approach showed a distinct pattern for the additional health problems: household interviews and open-ended questionnaires resulted in a higher ranking of problems that had not yet been solved by the health care facilities available in the community at the time of the interview. This view was further biased by the fact that the interviews were done by people representing the health professionals. The statistics from the registers of VHP clearly reflected the types of treatment provided by this service. Malnutrition and various eye problems only became evident during the clinical examination of the population. However, the clinical examination did not identify the importance of the abdominal problems in the community. The cross-sectional survey (questionnaires, clinical examination) chiefly showed the health problems affecting the population around the time of the surveys (end of the dry season). Interestingly, the registers of the VHP did not show marked seasonal variations in the morbidity statistics for this community. Both questionnaire approaches and the registers of VHP showed a change in both the morbidity and the disease perception pattern that may reflect the effects of interventions launched at community level (activities of village health workers, mass-treatment against hookworm and G. lamblia). The study indicated that the individual ranking of the major health problems matched with data from health status surveys. It also pointed to the possibility that disease perception patterns could become a tool for community diagnosis and for the monitoring of health care programs.
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PMID:Longitudinal study on the health status of children in a rural Tanzanian community: comparison of community-based clinical examinations, the diseases seen at village health posts and the perception of health problems by the population. 289 Dec 68

During the last 54 years at the Children's Hospital 11 children (10 female, 1 male) had been treated for an extragonadal germ cell tumor arising in the retroperitoneum. There were eight teratomas (five mature, three immature), two endodermal sinus tumors and one tumor with a mixture of both components. Abdominal pain or discomfort was the usual presenting complaint, with the average age at diagnosis being 18 months. On physical examination, each child had a palpable abdominal mass usually localized in the upper quadrants. The finding of calcification, bone or teeth, on radiologic study was most helpful in establishing a preoperative diagnosis of teratoma. The preferred treatment for children with mature and immature teratomas is complete surgical resection; decisions regarding adjuvant therapy for patients with immature tumors must be evaluated on an individual basis. The prognosis remains guarded for children with unresectable primaries or those with endodermal sinus tumor. Of three tumor-related deaths, two were due to metastatic endodermal sinus tumor and one resulted from extensive local growth by immature teratoma. Successful management of children with endodermal sinus tumor requires surgery aimed at debulking or complete resection in combination with aggressive adjuvant chemotherapy.
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PMID:Retroperitoneal germ cell tumors in childhood. A clinical and pathologic study of 11 cases. 298 49

Non-specific abdominal complaints are a very frequent cause of discomfort. Even if only comparatively few are brought to the attention of the physician, they account for a considerable portion of the reasons for seeking medical care, both in acute and chronic conditions. On the other hand, few drugs are free of the suspicion of causing abdominal complaints, which make up between one-tenth and one-third of reported adverse reactions. A wide variety of possible alternative or concomitant causes makes a clear causative attribution to suspected drugs very difficult. This holds especially true for the ill-defined conditions of indigestion and anorexia. For nausea and vomiting, specific scales have been developed which facilitate differentiation between drugs causing these effects most frequently and most intensively. They have been applied in cytostatic therapy, where this is one of the most frequently encountered problems, but nausea and vomiting can seriously affect compliance in many other treatments. Somatic abdominal pain results in most instances from the irritation of the parietal peritoneum and is usually the effect of a lesion. This may or may not be caused by a drug, but this cause should be the first consideration. Visceral pain may result from functional disturbance of secretory glands or of the muscular coat, from drug action on bowel content or from irritation of the mucosa, all of which are frequently interrelated. Most frequently suspected pharmacological causes are drugs with anticholinergic action, antibiotics, potassium supplements and non-steroidal, anti-inflammatory agents. Drug-induced hyperinsulinism and porphyria are rare cases. Abuse of laxatives should always be considered because of its prevalence. A great number of other untoward drug effects have been described in the literature, but rarely merit first consideration. With the exception of promptly occurring or persistent emesis, gastrointestinal symptoms usually are not pathognomonic for drug effects and are the result of several factors. The usual approach to identifying an adverse drug effect is to delineate the functional or structural disorder, and to associate this diagnosis with possible pharmacodynamic aetiologies.
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PMID:Abdominal pain, indigestion, anorexia, nausea and vomiting. 304 63

Polyhydramnios, which is caused by an excess of amniotic fluid, was diagnosed uniformly in eight patients by ultrasound examination and clinical symptoms, namely, premature uterine contraction, abdominal pain, and respiratory discomfort that resulted from excessive pressure on the diaphragm. Fetal anomalies incompatible with extrauterine existence were excluded by serum alpha-fetoprotein levels, repeated sonography, amniocentesis, and chromosomal analyses. Patients were treated with 2.2 to 3.0 mg of indomethacin/kg body weight/day. The treatment was started at an average gestational age of 24 +/- 0.5 weeks and continued for 2 to 11 weeks. All patients had significant improvement with a simultaneous reduction in amniotic fluid volume, fundal height, and umbilical perimeter. All patients were delivered satisfactorily at an average of 39 weeks' gestation. The fetuses were within the normal body weight range of 2750 to 3600 gm and showed normal development during the neonatal period of 2 to 6 months. Before delivery without indomethacin, the polyhydramnios reformed. Adverse effects or intolerance to the drug was avoided by either a reduction in the dose or cessation of indomethacin therapy. Our studies suggest that indomethacin therapy is an effective way to manage pregnancy complicated by polyhydramnios.
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PMID:Treatment of polyhydramnios with prostaglandin synthetase inhibitor (indomethacin). 311 51

Sixty-eight women with primary dysmenorrhea were randomly assigned to one of five four-times-daily treatment groups for a minimum of three days and a maximum of five days. Three of the groups received different initial single-daily doses of piroxicam, which were followed on each treatment day with placebo for the second through fourth doses, namely, piroxicam 20 mg daily for five days (piroxicam 20 mg for five days); piroxicam 40 mg on Day 1, followed by piroxicam 20 mg on Days 2 through 5 (piroxicam 40 mg for one day); and piroxicam 40 mg on Days 1 and 2, followed by piroxicam 20 mg on Days 3 through 5 (piroxicam 40 mg for two days). The fourth group received ibuprofen 400 mg four times per day, and the fifth group received placebo four times per day. Patients determined the severity of overall discomfort and pelvic-abdominal pain at baseline and prior to each dose using a four-point numerical scale. Supplemental ibuprofen, 400 mg four times per day, was provided for those patients requiring additional pain relief. Patients also made a global determination of overall relief at the end of the study. At 24 hours, the results revealed that piroxicam 40 mg for two days, piroxicam 20 mg for five days, and ibuprofen provided significantly more relief of overall discomfort compared with placebo (p = 0.003, p = 0.018, and p = 0.026, respectively). All four active treatment groups also experienced significantly more relief of pelvic-abdominal pain compared with placebo: piroxicam 40 mg for two days followed by three days of 20 mg (p = 0.002), piroxicam 40 mg for one day followed by four days of 20 mg (p = 0.023), piroxicam 20 mg for five days (p = 0.012), and ibuprofen (p = 0.011). A significantly smaller percentage of patients treated with piroxicam 40 mg for two days required supplemental medication as compared with those treated with piroxicam 20 mg for five days (p = 0.035) and patients treated with placebo (p = 0.010). A greater amount of overall relief was obtained by patients treated with piroxicam 40 mg for two days compared with patients treated with piroxicam 40 mg for one day (p = 0.041) and placebo-treated patients (p = 0.001). It was concluded that single daily doses of piroxicam 20 mg and 40 mg were as effective as ibuprofen, 400 mg four times per day, for the relief of primary dysmenorrhea.
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PMID:A double-blind, placebo-controlled study comparing three single-dose regimens of piroxicam with ibuprofen in patients with primary dysmenorrhea. 328 9

Despite the recognition of Mycobacterium avium complex (MAC) infection as a common complication of AIDS, the specific clinical features, significance, and need for treatment have been difficult to assess. We reviewed the clinical records and autopsy material of 68 patients dying with AIDS, 32 (47 percent) of whom had MAC isolated from autopsy tissue. All had postmortem evidence of systemic infection. Eleven (34 percent) had MAC isolated from lung tissue. Little, if any, local tissue inflammation and destruction were associated with MAC infection. Patients with autopsy evidence of MAC infection had a longer time interval from diagnosis of AIDS to death. The infection was detected antemortem in 14 (44 percent), blood culture being the most sensitive means (86 percent yield). Although recurrent fever was noted among both MAC infected and uninfected patients, weight loss greater than 20 lb, weakness, anorexia, abdominal pain, and diarrhea were more frequent among infected patients. Severe anemia, thrombocytopenia, lymphopenia, and reduced mean CD-4 percentages and CD-4/CD-8 ratios were associated with MAC infection. Of eight patients who had MAC cultured antemortem and received multidrug antituberculosis therapy, none responded clinically, and all but one had MAC isolated at autopsy. Because MAC is associated with significant discomfort and disability, development of more effective treatment regimens could be beneficial for some affected AIDS patients.
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PMID:Mycobacterium avium complex infection in patients with the acquired immunodeficiency syndrome. A clinicopathologic study. 335 47

Uncomplicated diverticular disease is usually asymptomatic. When abdominal pain or discomfort related to defecation, altered bowel habit, and flatulence occur, they are likely a result of a coexistent irritable bowel. Nonetheless, diverticula are subject to serious complications. Diverticular hemorrhage may be massive and require emergency angiography and segmental resection. Peridiverticulitis occurs when a diverticulum ruptures, perhaps because of inspissated fecal material. This occurs usually in the sigmoid, resulting in a peridiverticular abscess localized by the adjacent fat and mesentery. If the infection extends beyond this, abscess, fistula, or free perforation may occur. These complications require antibiotics, intravenous therapy, and, in the case of uncontrollable abscess or perforation, urgent surgery. Obstruction of the colon, sometimes associated with ileus, may occur and in this case one may find a carcinoma among extensive diverticular disease. Although there is insufficient evidence to justify a high-fiber diet for the general population, the notion of a low-residue diet in the management of uncomplicated diverticular disease should be laid to rest.
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PMID:Clinical picture of diverticular disease of the colon. 353 13

The experience of adverse gastrointestinal symptoms (gas, abdominal pain, and diarrhea) after the oral ingestion of 360 mL whole milk was investigated in 25 adults who claimed to be milk intolerant. The level of customary milk consumption by all subjects was low compared with that of 13 control subjects who denied a history of milk intolerance. After drinking the milk, which was accompanied by a hydrogen breath test, most of the subjects experienced some of their accustomed intestinal discomfort and the degree of intolerance was similar for the nine (36%) who proved to be true lactose-maldigester subjects and the 16 (64%) who had flat hydrogen breath responses, ie, who were classified as lactose-digester subjects. There is a subpopulation of lactose-intolerant milk-rejector individuals that absorbs lactose efficiently and responds to other milk-related factor(s) with the same subjective symptoms and dietary conduct as do true lactose-maldigester individuals.
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PMID:Milk consumption, symptom response, and lactose digestion in milk intolerance. 359 24

Gaucher's disease involves the liver, the spleen, and the bone. Liver-spleen and bone scintigraphy were used during an 8-yr period to evaluate changes caused by this disease. Patients were investigated with a liver-spleen scan for abdominal pain, mechanical discomfort, enlarged liver or spleen on physical examination, abdominal mass, abnormal liver function tests, and symptoms of hypersplenism. Fourteen liver-spleen scans were performed in nine patients. Liver scintigraphy showed various degrees of enlargement and inhomogeneous uptake. In two patients focal defects were detected. In one, focal defects were due to liver involvement with Gaucher's disease, but in the other they were caused by metastatic pancreatic carcinoma. The study was also useful in detecting splenic infarction and in following enlargement of the spleen after partial splenectomy. The main indication for bone scintigraphy in six patients was bone pain. This was found to be caused by either aseptic necrosis of the head of the femur, bone infarction, pathological fractures, or osteomyelitis. Loosening after total hip replacement was ruled out in three patients and missed in one patient. Scintigraphy appears to be a simple, sensitive test for evaluation of the liver, spleen, and bony skeleton in patients with symptomatic Gaucher's disease.
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PMID:Scintigraphic findings in Gaucher's disease. 376 Sep 80


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